Healthcare Capacity and Policy — COVID 19
As the nation enters Unlock 4.0, it will do us well to take a look at our healthcare capacity and how we are dealing with it. The focus is on the front line professionals and their families, who, even at the risk of getting affected, are attending the call of duty with limited resources.
Current Number of hospitals, beds, ventilators, doctors and healthcare workers
Estimates suggest approximately 19 lakh hospital beds, 95,000 ICU beds and 48,000 ventilators are available in India.
Most of the beds and ventilators in India, are concentrated in seven States — Uttar Pradesh (14.8%), Karnataka (13.8%), Maharashtra (12.2%), Tamil Nadu (8.1%), West Bengal (5.9%), Telangana (5.2%) and Kerala (5.2%).
Existing bed capacity is mostly saturated at government hospitals:
Note:
- The numbers are estimated values
- Height of column represents the total number of units (public + private in a particular State or Union Territory)
- No data available on Ladakh
- Data is as per a study published on April 20, 2020
There are total of 12,01,354 allopathic doctors registered with the State Medical Councils/Medical Council of India (MCI) as on 30th September, 2020.
The Covid-19 pandemic has added to the stress of an overburdened healthcare workforce. India has one medical doctor for every 1,404 people and 1.7 nurses per 1,000 people, according to the Ministry of Health and Family Welfare (MoHFW). This is lower than the World Health Organization (WHO) benchmark of one doctor and three nurses per 1,000 people.
However the number of doctors can’t be quickly increased since it takes approximately 6–12 years to acquire the necessary qualifications.
A total of 15,200 front-line workers and health care staff in India are infected by coronavirus says a report published on July 18, 2020.
The number can be higher since currently there are no centralized data collection systems that can collect information from public and private hospitals — especially smaller nursing homes.
A total of 196 doctors in the country, majority of them being general practitioners, have succumbed to COVID-19 so far, said the Indian Medical Association (IMA) in a letter to the Prime Minister requesting immediate focus on their safety and the morale of their families — according to an article on 8th Aug, 2020.
Lack of Personal Protective Equipment (PPEs) and inadequate sanitary arrangements in the hospitals are allegedly creating risk to the lives of the Health Care Workers (HCWs) while fighting the global pandemic — the recent strikes by nurses in Delhi holds mirror to the difficult situations in which they have to work.
Policy Interventions
The Central Government has directed the State Governments to utilize the funds available under District Mineral Foundation (DMF) Funds for supplementing and augmenting facilities of medical testing, screening and other requirements to combat COVID-19 as well as treating patients.
Incentive of Accident Insurance Cover of 50 lakhs per health workers who include Safai karamcharis, ward-boys, nurses, ASHA workers, paramedics, technicians, doctors, specialists and others in the domain.
NITI Aayog has recently published a call for doctors to volunteer to treat COVID-19 patients.
A complementary policy would be to train paramedical workers to conduct less skill-intensive tasks like routine check-ups, blood pressure monitoring, etc. to take some load off the trained doctors.
Unfortunately, COVID-19 pandemic does not stop patients suffering from other ailments from needing hospitalization or even outpatient healthcare services. During this time, more patients, especially non-urgent ones, should be encouraged to use telemedicine services as much as possible.
Some of the State-wise Policy interventions
Maharashtra
Free treatment for all COVID positive patients and payment according to Ayushman Bharat Norms.
Andhra Pradesh
YSR Telemedicine that makes doctors available online for outpatient services for COVID-19.
Tamilnadu
Door to door health checkups in Chennai, medication provided if needed; online registration facility created for Tamils living abroad who want to return to Tamlinadu.
Karnataka
Government will bear the cost of treatment for COVID 19 Patients referred by the Public Health Institutes (PHIs) to private healthcare providers.
Bihar
Government doctors and health employees to be paid an incentive equivalent to their one month’s basic pay.
Chattisgarh
‘Kawach’ mobile app provides real-time info on suspected and confirmed cases in the state, info about the nearest Corona hospitals, a feature for ordering home delivery for essential goods and details regarding donating to CM relief funds.
With India projected to hit its peak of 6.45 Lakh active cases on August 21 according to ‘most likely’ scenario and as per SEIR model, the peak is projected to be at 6.98 lakh active cases on August 23, the tough time is yet to pass.
Given these conditions, it is necessary that we as citizens cooperate with the administration and the front-line warriors namely doctors, nurses, sanitation workers and police force and take all necessary measures to fight the virus. We must remember that every act of carelessness on our part will result in implications not only on us and our family but also on the workforce in the health sector who were in critically meagre numbers even before the pandemic struck. This can have a major impact on the health of many more citizens who rely on these doctors and health care workers for their treatment.
Sources
